Answer_Book / Pet_Scan / PET SCAN

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This page is a Medicare-focused overview of PET scan coverage and billing. It covers nationally covered PET indications, registry-based coverage with evidence development, tracer and imaging code reporting, and related coverage topics for oncology, cardiac, and neurological PET services. It is intended for coders, billing staff, and clinicians who need to understand the general scope of PET reimbursement guidance and the code families referenced in the article.

Why This Topic Matters

PET imaging coverage and reimbursement can depend on the clinical indication, payer policy, registry participation, and correct reporting of the imaging service and tracer. Understanding the scope of this guidance helps offices and facilities determine whether the article is relevant to their PET billing workflow.

Article Sections

  1. Medicare coverage overview for PET

    Introduces PET as an imaging service and summarizes the Medicare coverage framework discussed in the article. Includes references to national coverage policy and documentation expectations.

  2. Get paid for PET under national registry

    Discusses registry-based PET coverage and participation requirements for certain services. Also references reimbursement handling for the imaging codes and radiopharmaceutical reporting.

  3. PET to diagnose, stage & monitor cancer

    Summarizes the article’s oncology-focused PET coverage discussion. Describes the general categories of cancer-related PET use addressed in the coverage table.

  4. PET payment for myocardial viability, coronary artery disease diagnosis and management

    Covers the cardiac PET topics discussed in the article, including myocardial viability and perfusion-related imaging. Mentions the related tracer and comparison to other imaging modalities.

  5. PET scans for diagnosis of Alzheimer’s

    Addresses neurological PET coverage topics related to dementia and Alzheimer’s evaluation. Includes the diagnosis-code group referenced for this coverage discussion.

  6. CPT codes replace G codes for PET scans

    Lists the PET imaging procedure codes referenced in the article and notes the transition from earlier reporting formats. Includes brain, cardiac, oncology, and PET/CT code families.

  7. Selecting the right tracer code

    Explains the article’s tracer-and-service matching overview. Includes the radiopharmaceutical billing codes and the accompanying PET scan code groupings.

What You Will Learn

  • How Medicare PET coverage is organized across different clinical uses
  • Which general PET service categories are discussed in national coverage policy
  • How registry participation affects PET reimbursement topics
  • What code families are referenced for PET imaging and radiopharmaceutical agents
  • Which broad diagnostic areas are addressed for PET coverage review
  • How the article frames tracer selection in relation to PET services

Who Should Read This

  • Medical coders
  • Billing staff
  • Radiology practices
  • Nuclear medicine providers
  • Physician offices
  • Compliance staff

Codes Discussed

Code Ranges Discussed

  • ICD-9-CM: 290.10–290.13
  • ICD-9-CM: 290.20–290.21
  • CPT: 78811–78813
  • CPT: 78814–78816

Modifiers Discussed


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